自由分娩体位对分娩结局的影响研究进展
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摘要
<正>1996年WHO在《正常分娩监护实用手册》提出,自由体位分娩使产妇更舒适,更符合生理体位,有利于自然分娩。因此,近年来新型分娩体位即自由分娩体位的临床研究和应用受到各国学者重视。自由分娩体位是指产妇在产程中可自由选择舒适体位,包括卧、走、坐、立、跪、趴、蹲等姿势,而不是静卧在床或固定某种体位。相比于卧位,走、坐、立、跪、蹲等自由体位又称为直立式体位。本文就现有的科学证据,关于自由分娩体位对分娩结局和围产期健康影响,以及阻碍产妇在产程中自
引文
[1] LAWRENCE A, LEWIS L, HOFMEYR G J, et al.Maternal positions and mobility during first stage Labour [J].Cochrane Database of Systematic Reviews, 2009,(2): CD003934.
[2] 张晓丽,张惠欣,蒋睿,等.不同体位分娩对妊娠结局的临床观察 [J].中国妇幼保健,2016,29(9):1814-1816.
[3] ROBERTS J E, MENDEZ-BAUER C, WODELL D A.The effects of maternal position on uterine contractility and efficiency [J].Birth (Berkeley, Calif.), 1983, 10 (4): 243-249.
[4] GUPTA J K, HOFMEYR G J, SHEHMAR M.Position in the second stage of Labour for women without epidural anaesthesia [J].The Cochrane Database of Systematic Reviews, 2012 (5): CD002006.
[5] Kibuka M, Thornton J G, Kingswood C J.Position in the second stage of labour for women with epidural anaesthesia [J].Cochrane Database Syst Rev, 2004, 5 (5):74-80.
[6] 甘新春, 张卫, 左美华,等.足月妊娠初产妇第二产程蹲位分娩对其产程的影响 [J].中国当代医药, 2017, 24 (13):103-105.
[7] 李晶,纪艳洁.立式体位对分娩的影响 [J].中国医药指南,2011,9(20):324-325.
[8] 陈慧娟,吴蕾,付锦艳.新产程标准中第二产程时长对产妇和新生儿结局的影响研究[J].中华护理杂志,2016,51(10):1170-1173.
[9]REITTER A, DAVISS B A, BISITS A, et al.Does pregnancy and/or shifting positions create more room in a woman's pelvis? [J].American Journal of Obstetrics and Gynecology, 2014, 211 (6): 661-662.
[10] DE JONGE A, VAN D M, SCHEEPERS P L, et al.Risk of perineal damage is not a reason to discourage a sitting birthing position:a secondary analysis [J].International Journal of Clinical Practice, 2010, 64 (5): 611-618.
[11] LACROSS A, GROFF M, SMALDONE A.Obstetric anal sphincter injury and anal incontinence following vaginal birth: a systematic review and meta-analysis [J].Journal of Midwifery & Women's Health, 2015, 60 (1): 37-47.
[12] DAHLEN H G, RYAN M, HOMER C S, et al.An Australian prospective cohort study of risk factors for severe perineal trauma during childbirth [J].Midwifery, 2007, 23 (2): 196-203.
[13] SOONG B, BARNES M.Maternal position at midwife-attended birth and perineal trauma: is there an association? [J].Birth (Berkeley, Calif.), 2005, 32 (3): 164-169.
[14] Zhang H, Huang S, Guo X, et al.A randomised controlled trial in comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position in China [J].Midwifery, 2017,50: 117-124.
[15] SHORTEN A, DONSANTE J, POSITION S B, et al.And perineal outcomes:informing women about choices for vaginal birth [J].Birth (Berkeley, Calif.), 2002, 29 (1): 18-27.
[16] GUROL-URGANCI I, CROMWELL D A, EDOZIEN L C, et al.Third-and fourth-degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors [J].BJOG-An International Journal of Obstetrics and Gynaecology, 2013, 120 (12): 1516-1525.
[17] 计轶亚.体位管理对枕后位、枕横位产妇分娩影响的临床研究 [J].中国继续医学教育,2017,9(4):208-209.
[18] Guittier M, Otheningirard V, Irion O, et al.Maternal positioning to correct occipito-posterior fetal position in labour: a randomised controlled trial [J].BMC Pregnancy and Childbirth, 2014, 14 (1): 83.
[19] HUNTER S H G. Knees posture in late pregnancy or labour for fetal malposition.Lateral or posterior [J].The Cochrane Database of Systematic Reviews, 2007 (4): CD001063.
[20] 高坤炀,刘荆银,蒋睿.两种体位矫正持续性枕后位提高自然分娩成功率及妊娠结局分析 [J].中国计划生育和妇产科,2016,8(8):69-71.
[21] 杨春荣,白润芳,刘晓琴,等.初产妇足月头位未衔接胎膜早破临产前体位管理[J].中国妇产科临床杂志,2016,17(5):460-461.
[22] DE JONGE A, VAN DIEM M T, SCHEEPERS P L, et al.Increased blood loss in upright birthing positions originates from perineal damage [J].BJOG-An International Journal of Obstetrics and Gynaecology, 2007, 114 (3): 349-355.
[23] DE JONGE A, TEUNISSEN T A, LAGRO-JANSSEN A L.Supine position compared to other positions during the second stage of labor: a meta-analytic review [J].Journal of Psychosomatic Obstetrics and Gynaecology, 2004, 25 (1): 35-45.
[24] JAFARI E, MOHEBBI P, MAZLOOMZADEH S.Factors related to women's childbirth satisfaction in physiologic and routine childbirth groups [J].Iranian Journal of Nursing and Midwifery Research, 2017, 22 (3): 219-224.
[25] NIEUWENHUIJZE M J, DE JONGE A, KORSTJENS I, et al.Influence on birthing positions affects women's sense of control in second stage of Labour [J].Midwifery, 2013, 29 (11): e107-e114.
[26] FORD E, AYERS S, WRIGHT D B.Measurement of maternal perceptions of support and control in birth (SCIB) [J].Journal of Women's Health (2002), 2009, 18 (2): 245-252.
[27] TURKELI G, OZ M, KUSCU E, et al.The effects of maternal position on labour and obstetric outcomes,aprospective,randomized trial [J].Turk KlinikleriJinekolojiObstet, 2016, 26 (1): 7-12.
[28] 郑新燕.自由体位在改善产妇分娩疼痛感及分娩效能感中的效果观察 [J].中国妇幼保健,2017,30(12):2567-2569.
[29] DAHLEN H G, BARCLAY L M, HOMER C S.The novice birthing: theorising first-time mothers' experiences of birth at home and in hospital in Australia [J].Midwifery, 2010, 26 (1): 53-63.
[30] ZILENI B D, GLOVER P, JONES M, et al.Malawi women's knowledge and use of labour and birthing positions: A cross-sectional descriptive survey [J].Women and Birth : Journal of the Australian College of Midwives, 2017, 30 (1): e1-e8.
[31] LUGINA H, MLAY R, SMITH H.Mobility and maternal position during childbirth in Tanzania: an exploratory study at four government hospitals [J].BMC Pregnancy and Childbirth, 2004, 4 (1): 3.
[32] SANDALL J, SOLTANI H, GATES S, et al.Midwife‐led continuity models versus other models of care for childbearing women [J].Cochrane Database of Systematic Reviews, 2016, 4 (8): 1-107.
[33] DE JONGE A, TEUNISSEN D A, VAN DIEM M T, et al.Women's positions during the second stage of labour: views of primary care midwives [J].Journal of Advanced Nursing, 2008, 63 (4): 347-356.
[34] DE JONGE A, RIJNDERS M E, VAN DIEM M T, et al.Are there inequalities in choice of birthing position? Sociodemographic and labour factors associated with the supine position during the second stage of labour [J].Midwifery, 2009, 25 (4): 439-448.
[35] 江紫妍,黄美凌,陈丽华,等.孕妇对自由体位分娩的认知及需求现状调查 [J].中华现代护理杂志,2016,22(36):5216-5218.
[36] 罗琳虹,郭实贤,郑巧丽.产程中不同体位与运动对分娩结局的影响 [J].中国计划生育和妇产科,2015,7(12):30-32.
[37] 李萍,陈红,赵虎,等.妊娠期肝内胆汁淤积症患者的分娩方式探讨 [J].中国计划生育和妇产科,2014,6(5):69-71.
[2] 张晓丽,张惠欣,蒋睿,等.不同体位分娩对妊娠结局的临床观察 [J].中国妇幼保健,2016,29(9):1814-1816.
[3] ROBERTS J E, MENDEZ-BAUER C, WODELL D A.The effects of maternal position on uterine contractility and efficiency [J].Birth (Berkeley, Calif.), 1983, 10 (4): 243-249.
[4] GUPTA J K, HOFMEYR G J, SHEHMAR M.Position in the second stage of Labour for women without epidural anaesthesia [J].The Cochrane Database of Systematic Reviews, 2012 (5): CD002006.
[5] Kibuka M, Thornton J G, Kingswood C J.Position in the second stage of labour for women with epidural anaesthesia [J].Cochrane Database Syst Rev, 2004, 5 (5):74-80.
[6] 甘新春, 张卫, 左美华,等.足月妊娠初产妇第二产程蹲位分娩对其产程的影响 [J].中国当代医药, 2017, 24 (13):103-105.
[7] 李晶,纪艳洁.立式体位对分娩的影响 [J].中国医药指南,2011,9(20):324-325.
[8] 陈慧娟,吴蕾,付锦艳.新产程标准中第二产程时长对产妇和新生儿结局的影响研究[J].中华护理杂志,2016,51(10):1170-1173.
[9]REITTER A, DAVISS B A, BISITS A, et al.Does pregnancy and/or shifting positions create more room in a woman's pelvis? [J].American Journal of Obstetrics and Gynecology, 2014, 211 (6): 661-662.
[10] DE JONGE A, VAN D M, SCHEEPERS P L, et al.Risk of perineal damage is not a reason to discourage a sitting birthing position:a secondary analysis [J].International Journal of Clinical Practice, 2010, 64 (5): 611-618.
[11] LACROSS A, GROFF M, SMALDONE A.Obstetric anal sphincter injury and anal incontinence following vaginal birth: a systematic review and meta-analysis [J].Journal of Midwifery & Women's Health, 2015, 60 (1): 37-47.
[12] DAHLEN H G, RYAN M, HOMER C S, et al.An Australian prospective cohort study of risk factors for severe perineal trauma during childbirth [J].Midwifery, 2007, 23 (2): 196-203.
[13] SOONG B, BARNES M.Maternal position at midwife-attended birth and perineal trauma: is there an association? [J].Birth (Berkeley, Calif.), 2005, 32 (3): 164-169.
[14] Zhang H, Huang S, Guo X, et al.A randomised controlled trial in comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position in China [J].Midwifery, 2017,50: 117-124.
[15] SHORTEN A, DONSANTE J, POSITION S B, et al.And perineal outcomes:informing women about choices for vaginal birth [J].Birth (Berkeley, Calif.), 2002, 29 (1): 18-27.
[16] GUROL-URGANCI I, CROMWELL D A, EDOZIEN L C, et al.Third-and fourth-degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors [J].BJOG-An International Journal of Obstetrics and Gynaecology, 2013, 120 (12): 1516-1525.
[17] 计轶亚.体位管理对枕后位、枕横位产妇分娩影响的临床研究 [J].中国继续医学教育,2017,9(4):208-209.
[18] Guittier M, Otheningirard V, Irion O, et al.Maternal positioning to correct occipito-posterior fetal position in labour: a randomised controlled trial [J].BMC Pregnancy and Childbirth, 2014, 14 (1): 83.
[19] HUNTER S H G. Knees posture in late pregnancy or labour for fetal malposition.Lateral or posterior [J].The Cochrane Database of Systematic Reviews, 2007 (4): CD001063.
[20] 高坤炀,刘荆银,蒋睿.两种体位矫正持续性枕后位提高自然分娩成功率及妊娠结局分析 [J].中国计划生育和妇产科,2016,8(8):69-71.
[21] 杨春荣,白润芳,刘晓琴,等.初产妇足月头位未衔接胎膜早破临产前体位管理[J].中国妇产科临床杂志,2016,17(5):460-461.
[22] DE JONGE A, VAN DIEM M T, SCHEEPERS P L, et al.Increased blood loss in upright birthing positions originates from perineal damage [J].BJOG-An International Journal of Obstetrics and Gynaecology, 2007, 114 (3): 349-355.
[23] DE JONGE A, TEUNISSEN T A, LAGRO-JANSSEN A L.Supine position compared to other positions during the second stage of labor: a meta-analytic review [J].Journal of Psychosomatic Obstetrics and Gynaecology, 2004, 25 (1): 35-45.
[24] JAFARI E, MOHEBBI P, MAZLOOMZADEH S.Factors related to women's childbirth satisfaction in physiologic and routine childbirth groups [J].Iranian Journal of Nursing and Midwifery Research, 2017, 22 (3): 219-224.
[25] NIEUWENHUIJZE M J, DE JONGE A, KORSTJENS I, et al.Influence on birthing positions affects women's sense of control in second stage of Labour [J].Midwifery, 2013, 29 (11): e107-e114.
[26] FORD E, AYERS S, WRIGHT D B.Measurement of maternal perceptions of support and control in birth (SCIB) [J].Journal of Women's Health (2002), 2009, 18 (2): 245-252.
[27] TURKELI G, OZ M, KUSCU E, et al.The effects of maternal position on labour and obstetric outcomes,aprospective,randomized trial [J].Turk KlinikleriJinekolojiObstet, 2016, 26 (1): 7-12.
[28] 郑新燕.自由体位在改善产妇分娩疼痛感及分娩效能感中的效果观察 [J].中国妇幼保健,2017,30(12):2567-2569.
[29] DAHLEN H G, BARCLAY L M, HOMER C S.The novice birthing: theorising first-time mothers' experiences of birth at home and in hospital in Australia [J].Midwifery, 2010, 26 (1): 53-63.
[30] ZILENI B D, GLOVER P, JONES M, et al.Malawi women's knowledge and use of labour and birthing positions: A cross-sectional descriptive survey [J].Women and Birth : Journal of the Australian College of Midwives, 2017, 30 (1): e1-e8.
[31] LUGINA H, MLAY R, SMITH H.Mobility and maternal position during childbirth in Tanzania: an exploratory study at four government hospitals [J].BMC Pregnancy and Childbirth, 2004, 4 (1): 3.
[32] SANDALL J, SOLTANI H, GATES S, et al.Midwife‐led continuity models versus other models of care for childbearing women [J].Cochrane Database of Systematic Reviews, 2016, 4 (8): 1-107.
[33] DE JONGE A, TEUNISSEN D A, VAN DIEM M T, et al.Women's positions during the second stage of labour: views of primary care midwives [J].Journal of Advanced Nursing, 2008, 63 (4): 347-356.
[34] DE JONGE A, RIJNDERS M E, VAN DIEM M T, et al.Are there inequalities in choice of birthing position? Sociodemographic and labour factors associated with the supine position during the second stage of labour [J].Midwifery, 2009, 25 (4): 439-448.
[35] 江紫妍,黄美凌,陈丽华,等.孕妇对自由体位分娩的认知及需求现状调查 [J].中华现代护理杂志,2016,22(36):5216-5218.
[36] 罗琳虹,郭实贤,郑巧丽.产程中不同体位与运动对分娩结局的影响 [J].中国计划生育和妇产科,2015,7(12):30-32.
[37] 李萍,陈红,赵虎,等.妊娠期肝内胆汁淤积症患者的分娩方式探讨 [J].中国计划生育和妇产科,2014,6(5):69-71.